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Biomedical subjects

B R Lunsford

Publications and source records attributed to B R Lunsford.

8 recordsLinked to original sources
PubMed1995

The standing heel-rise test for ankle plantar flexion: criterion for normal.

BACKGROUND AND PURPOSE: Manual muscle testing with the examiner providing the resistance has long been a standard test of muscle strength. Through the use of extremities acting as levers, clinicians have been able to effectively apply resistance to all muscle groups except the ankle plantar flexors. As a result, a standing heel-rise test that uses body weight as the resistance has been substituted. The number of heel-rises that represent normal plantar-flexor "strength" and the ability of subjects to repeatedly use that "strength" remain unresolved. Because walking is an endurance task, the hypothesis tested by this study was that individuals without known weakness would be able to perform more than the standard recommended one to five standing heel-rises. The purpose of this study was to measure the number of standing heel-rises that individuals without known weakness could accomplish. SUBJECTS: Two hundred three subjects were studied for their ability to do standing heel-rises, as is done when testing plantar-flexion strength using the upright test. There were 122 male subjects and 81 female subjects, ranging in age from 20 to 59 years. METHODS: Each subject was asked to do as many standing heel-rises as he or she could, with careful monitoring of body and limb alignment and of ankle motion, with specific criteria for stopping. RESULTS: The average number of heel-rises was 27.9 (SD = 11.1, minimum = 6, maximum = 70) for all groups and both genders, with no differences between male and female subjects. The lower 99% confidence interval was 25. CONCLUSION AND DISCUSSION: A recommendation is made to change the standard of testing plantar-flexion function, when using the standing heel-rise test, to require 25 repetitions for a grade of Normal. [Lunsford BR, Perry J. The standing heel-rise test for ankle plantar flexion: criterion for normal.

Adult↗
PubMed1989

The use of dynamic electromyography to evaluate motor control in the hands of adults who have spasticity caused by brain injury.

A dynamic electromyographic analysis of grasp and release, performed on forty-eight upper extremities of forty-two adults who had had injury to the brain causing spasticity, showed volitional motor control of the finger flexors in 80 per cent and active extension of the fingers in 60 per cent. The flexor pollicis longus showed volitional control in 75 per cent of the hands and the extensor pollicis longus showed active control in 50 per cent. The extensor carpi radialis longus acted as an appropriate stabilizer of the wrist in 85 per cent of the extremities. Fourteen muscles had out-of-phase activity that could not be detected on clinical examination. The position of the elbow did not appreciably influence the electromyographic pattern of motor control in the hand.

Adolescent↗
PubMed1988

Energy-speed relationship of walking: standard tables.

The energy expenditure of level walking was measured in 260 normal male and female subjects walking around a 60.5m-circular outdoor track. Subjects were divided into four age groups (children, 6-12 years; teens; young adults, 20-59 years; and senior adults, 60-80 years). Oxygen consumption was measured with a modified Douglas Bag technique during the fourth and fifth minutes of each trial. Standard tables according to age and sex were derived for the average energy expenditure (rate of oxygen uptake, energy cost per meter, and heart rate) and for the gait characteristics (speed, cadence, stride length) at the subjects' customary slow, normal, and fast walking speeds. Statistical analysis was performed to determine the energy-speed relationship for the different age groups to derive normative tables for the rate of oxygen uptake throughout the range of customary walking velocities.

Adolescent↗
PubMed1985

Energy cost of paraplegic locomotion.

We measured the physiological energy expenditure that was associated with several modes of mobility in 151 individuals with paraplegia that resulted from spinal cord injury. The relationship of the neurological level of the spinal lesion, extent of paralysis, orthotic requirement, and type of gait pattern was evaluated. The patients who required a bilateral knee-ankle-foot orthosis in order to walk with a swing-through crutch-assisted gait had an average rate of oxygen consumption that was 43 per cent greater than that of the patients who used a wheelchair and 38 per cent greater than was required for normal walking. Their average walking speed was slow in comparison with wheelchair propulsion or normal walking. Furthermore, the paraplegics in whom the hip flexor and knee extensor muscles were intact bilaterally and who were able to walk with a reciprocal crutch-assisted gait, but did not require knee-ankle-foot orthoses, did no better. They had a rate of oxygen consumption that was 20 per cent greater than that required for wheelchair use and 15 per cent greater than that required for normal walking. In addition, their mean walking speed was the slowest of all of the groups. These findings account for the common clinical experience that most paraplegics who require a knee-foot-ankle orthosis bilaterally and use a swing-through crutch-assisted gait prefer to use a wheelchair, and discontinue walking as the primary means of mobilization after gait-training.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1981

Respiratory treatment of the adult patient with spinal cord injury.

The respiratory program of the Spinal Injury Service at Rancho Los Amigos Hospital has demonstrated effective respiratory treatment to be a prerequisite for comprehensive rehabilitation. To facilitate program planning, patients are classified according to functional neurosegmental levels and residual respiratory muscles. Breathing mechanics are the basis of evaluation and treatment. Evaluative elements are strength of residual respiratory muscles, respiratory rate, vital capacity, breathing pattern, chest expansion, and cough. Respiratory functions of patients with spinal injury are compared with respiratory functions of healthy subjects. Treatment objectives are prepared according to the individual patient's functional classification and evaluation. Specific methods are discussed, including strengthening, chest wall mobilization, external support devices, and bronchial hygiene.

Adult↗
PubMed1981

Cardiac rehabilitation: evaluation and intervention less than 6 weeks after myocardial infarction.

Twenty-nine patients having myocardial infarction (MI) of recent origin (6 weeks or less) were evaluated and treated using a program in which assessment and progression were based not on generalized data but on the individual responses of each patient. Fourteen patients had complications including left ventricular impairment, continuing ischemia or rhythm disturbances, and 15 did not. Cardiac tolerance for the common self-care activities, walking and light exercise, was objectively defined by 3 levels of functional monitoring. The physician, occupational therapist and physical therapist evaluated the patient's responses to mild exertion, utilizing a 12-lead electrocardiogram (ecg), physical examination, 24-hour monitoring with a portable ecg, self-care evaluation and a modified treadmill screening test. Patient performance was assessed at each stage of testing and individualized activity levels were determined in accordance with cardiac responses. Thus patients progressed at their optimum rate with safety and without loss of time, ie, artificially induced invalidism. Following the 1st self-care evaluation, 3 patients were ordered to bedrest for further medical treatment while 26 were cleared for ward activity. When their conditions improved the 3 patients were reevaluated and began the program. The 15 patients without complications had appropriate responses to activity and proceeded to a mild exercise program with minimal observation. Of the 14 with complications, 5 experienced a temporary program interruption and 2 were dropped from the program secondary to severity of complications. The remaining 7 were progressed in the same manner as those without complication.

Adult↗